PhilHealth approved P600-M denied hospital claims, alleges Barbers

A lawmaker on Friday questioned PhilHealth's payment of P600 million worth of late claims to hospitals under an amnesty program, saying that such claims cannot turn valid after being initially rejected by the state insurer.

Surigao del Norte Rep. Robert Ace Barbers said that PhilHealth approved the grant of P600 million of claims to hospitals last May 14 although they were already rejected from 2011 to 2019 by the PhilHealth’s Protest Appeals and Review Department (PARD).

“In an unexplainable sudden turn of events last May 2020, without the required detailed evaluation of each claim, PARD reversed its decisions and decided to grant its version of an 'amnesty' by paying all these hospitals," Barbers said in a statement.

"How can the PARD and former [PhilHealth] Senior Vice President [Rodolfo] del Rosario justify this very anomalous deal? PARD is under the office of del Rosario," he added.

Barbers argued that each claim should have undergone detailed scrutiny and evaluation before being reconsidered, and that the evaluations of claims from two to nine years ago strike as an anomaly.

"If the reason for resuscitating them is because Philhealth erred, then these officials are liable for gross negligence and gross neglect of duty under the Anti-Graft and Corrupt Practices Act, for sitting on these transactions all these years," Barbers said.

Barbers then said that the swiftness of such reversal could only mean that the PhilHealth Board did not exercise due diligence and blindly approved the recommendations for "amnesty" of PARD and SVP del Rosario. 

"In a matter of days, PARD has reversed years-old decisions and succeeded in getting a Board approval for more than P600 million.They are all grossly negligent and entered into a deal that is grossly disadvantageous to the government," Barbers said. 

"It is just like peanuts for them.  What is in it for PARD, SVP del Rosario and the Philhealth Mafia?"

GMA News Online have reached out to PhilHealth for confirmation of the payment of P600 million but is yet to receive a reply as of posting time.

PhilHealth has been under probe by Congress and a government task force over alleged corruption of its fund involving the advance payment to hospitals and healthcare facilities, including those not dealing with COVID-19 patients under the now-suspended Internal Reimbursement Mechanism (IRM); overpriced IT project and paying withholding tax using PhilHealth’s operating fund, among others.

The investigations have already prompted the resignation of PhilHealth president and CEO Ricardo Morales and del Rosario.

President Rodrigo Duterte has since appointed former National Bureau of Investigation chief Dante Gierran to replace Morales. --KBK, GMA News